Affordable Care Act Gives Workers New Mobility

Health insurance guarantees make it easier to change careers, retire early

Don't miss the March 31 deadline for signing up for health insurance this year! — Michael Austin/Ispot

Remember when worried working people said, "I'm just a pink slip away from being uninsured"? Those days are gone.

For all the back and forth about the Affordable Care Act, one clear good has emerged for those in middle life: You're no longer nailed to your job in order to get health insurance. For the first time, you're free to make life and career choices without regard to where or whether you choose to work.

The ACA requires insurance companies to sell you a policy regardless of your health. They can't cancel it or raise its price just because you get sick.

With this guarantee, you can rewrite your plans for the second chapter of your life. For example, you can now be assured of health care if you retire early, even if you don't have a retiree plan. You can leave a big company to join (or start) a small business that doesn't offer benefits. If one spouse retires early, the other one doesn't have to keep working just to maintain the family's medical coverage. You don't have to worry that a huge medical debt will wipe you out.

Thinking about quitting?

In some cases, you might decide to stick with your job even if you'd rather not. Employer group plans generally cost less than the sticker price of individual plans. But check the ACA Marketplace anyway (healthcare.gov takes you to your state's website). If you quit and buy ACA coverage, you might get a subsidy that reduces the policy's expense.

Subsidies, in the form of tax credits, go to people with modified adjusted gross incomes — including interest, dividends, capital gains and other sources — between 100 percent and 400 percent of the poverty level. This year, that means individuals whose incomes range from $11,490 to $45,960; for couples, $15,510 to $62,040. The cutoff point rises with family size.

There are four groups of plans: Bronze, Silver, Gold and Platinum. As you go up the value ladder, the plans charge higher premiums but reduce out-of-pocket costs. If you rarely see a doctor, a Bronze plan may do fine. If you have a chronic illness or see surgery ahead, you might choose Gold or Platinum. If the cheapest plan costs more than 8 percent of your income or you're a hardship case, you can buy a low-premium "catastrophic" policy. For those with especially low incomes, there's a modified Silver plan that slashes copays and coinsurance.

You can change plans once a year. This year's final deadline for signing up is March 31, unless you have a qualifying event such as getting married or having a baby. Subsidies for ACA plans are figured on a sliding scale. A buyer at the poverty level has to pay no more than 2 percent of his or her income toward the annual premium for the second-cheapest Silver plan. At the upper end of the income range, your expected payment is capped at 9.5 percent of income. You can use your premium subsidy to help buy a Gold or Platinum plan but will have to shoulder the extra cost yourself.